ALTERNATIVE CONSIDERED - COMPOSITION OF LOW-VOLUME QUINTILES FOR MS-LTC-DRGs FY 2022	
MS-LTC-DRG	MS-LTC-DRG Description
Quintile 1	
65	Intracranial hemorrhage or cerebral infarction with CC or tPA in 24 hours
72	Nonspecific cerebrovascular disorders without CC/MCC
78	Hypertensive encephalopathy with CC
92	Other disorders of nervous system with CC
93	Other disorders of nervous system without CC/MCC
102	Headaches with MCC
141	Major head and neck procedures with CC
148	"Ear, nose, mouth and throat malignancy without CC/MCC"
159	Dental and oral diseases without CC/MCC
181	Respiratory neoplasms with CC
187	Pleural effusion with CC
192	Chronic obstructive pulmonary disease without CC/MCC
195	Simple pneumonia and pleurisy without CC/MCC
201	Pneumothorax without CC/MCC
203	Bronchitis and asthma without CC/MCC
206	Other respiratory system diagnoses without MCC
220	Cardiac valve and other major cardiothoracic procedures without cardiac catheterization with CC
259	Cardiac pacemaker device replacement without MCC
266	Endovascular cardiac valve replacement and supplement procedures with MCC
281	"Acute myocardial infarction, discharged alive with CC"
293	Heart failure and shock without CC/MCC
301	Peripheral vascular disorders without CC/MCC
303	Atherosclerosis without MCC
305	Hypertension without MCC
310	Cardiac arrhythmia and conduction disorders without CC/MCC
369	Major esophageal disorders with CC
373	Major gastrointestinal disorders and peritoneal infections without CC/MCC
390	Gastrointestinal obstruction without CC/MCC
395	Other digestive system diagnoses without CC/MCC
436	Malignancy of hepatobiliary system or pancreas with CC
467	Revision of hip or knee replacement with CC
535	Fractures of hip and pelvis with MCC
543	Pathological fractures and musculoskeletal and connective tissue malignancy with CC
554	Bone diseases and arthropathies without MCC
561	"Aftercare, musculoskeletal system and connective tissue without CC/MCC"
566	Other musculoskeletal system and connective tissue diagnoses without CC/MCC
577	Skin graft except for skin ulcer or cellulitis with CC
594	Skin ulcers without CC/MCC
605	"Trauma to the skin, subcutaneous tissue and breast without MCC"
644	Endocrine disorders with CC
645	Endocrine disorders without CC/MCC
662	Minor bladder procedures with MCC
687	Kidney and urinary tract neoplasms with CC
695	Kidney and urinary tract signs and symptoms with MCC
776	Postpartum and post abortion diagnoses without O.R. procedures
918	Poisoning and toxic effects of drugs without MCC
921	Complications of treatment without CC/MCC
927	Extensive burns or full thickness burns with MV >96 hours with skin graft
941	O.R. procedures with diagnoses of other contact with health services without CC/MCC
948	Signs and symptoms without MCC
950	Aftercare without CC/MCC
Quintile 2	
23	Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC or chemotherapy implant or epilepsy with neurostimulator
55	Nervous system neoplasms without MCC
58	Multiple sclerosis and cerebellar ataxia with MCC
60	Multiple sclerosis and cerebellar ataxia without CC/MCC
75	Viral meningitis with CC/MCC
77	Hypertensive encephalopathy with MCC
86	Traumatic stupor and coma <1 hour with CC
96	Bacterial and tuberculous infections of nervous system without CC/MCC
101	Seizures without MCC
147	"Ear, nose, mouth and throat malignancy with CC"
154	"Other ear, nose, mouth and throat diagnoses with MCC"
158	Dental and oral diseases with CC
197	Interstitial lung disease with CC
271	Other major cardiovascular procedures with CC
309	Cardiac arrhythmia and conduction disorders with CC
313	Chest pain
316	Other circulatory system diagnoses without CC/MCC
375	Digestive malignancy with CC
378	Gastrointestinal hemorrhage with CC
408	Biliary tract procedures except only cholecystectomy with or without C.D.E. with MCC
418	Laparoscopic cholecystectomy without C.D.E. with CC
435	Malignancy of hepatobiliary system or pancreas with MCC
442	"Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CC"
504	Foot procedures with CC
533	Fractures of femur with MCC
536	Fractures of hip and pelvis without MCC
546	Connective tissue disorders with CC
552	Medical back problems without MCC
553	Bone diseases and arthropathies with MCC
555	Signs and symptoms of musculoskeletal system and connective tissue with MCC
556	Signs and symptoms of musculoskeletal system and connective tissue without MCC
562	"Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCC"
572	Skin debridement without CC/MCC
595	Major skin disorders with MCC
596	Major skin disorders without MCC
600	Non-malignant breast disorders with CC/MCC
639	Diabetes without CC/MCC
684	Renal failure without CC/MCC
696	Kidney and urinary tract signs and symptoms without MCC
697	Urethral stricture
712	Testes procedures without CC/MCC
803	Other O.R. procedures of the blood and blood forming organs with CC
834	Acute leukemia without major O.R. procedures with MCC
841	Lymphoma and non-acute leukemia with CC
843	Other myeloproliferative disorders or poorly differentiated neoplastic diagnoses with MCC
868	Other infectious and parasitic diseases diagnoses with CC
869	Other infectious and parasitic diseases diagnoses without CC/MCC
903	Wound debridements for injuries without CC/MCC
934	Full thickness burn without skin graft or inhalation injury
935	Non-extensive burns
975	HIV with major related condition with CC
977	HIV with or without other related condition
Quintile 3	
54	Nervous system neoplasms with MCC
59	Multiple sclerosis and cerebellar ataxia with CC
80	Nontraumatic stupor and coma with MCC
84	Traumatic stupor and coma >1 hour without CC/MCC
146	"Ear, nose, mouth and throat malignancy with MCC"
153	Otitis media and URI without MCC
155	"Other ear, nose, mouth and throat diagnoses with CC"
176	Pulmonary embolism without MCC
179	Respiratory infections and inflammations without CC/MCC
180	Respiratory neoplasms with MCC
196	Interstitial lung disease with MCC
200	Pneumothorax with CC
246	Percutaneous cardiovascular procedures with drug-eluting stent with MCC or 4+ arteries or stents
304	Hypertension with MCC
307	Cardiac congenital and valvular disorders without MCC
312	Syncope and collapse
368	Major esophageal disorders with MCC
374	Digestive malignancy with MCC
381	Complicated peptic ulcer with CC
386	Inflammatory bowel disease with CC
389	Gastrointestinal obstruction with CC
424	Other hepatobiliary or pancreas O.R. procedures with CC
439	Disorders of pancreas except malignancy with CC
440	Disorders of pancreas except malignancy without CC/MCC
445	Disorders of the biliary tract with CC
462	Bilateral or multiple major joint procedures of lower extremity without MCC
501	Soft tissue procedures with CC
541	Osteomyelitis without CC/MCC
542	Pathological fractures and musculoskeletal and connective tissue malignancy with MCC
549	Septic arthritis with CC
580	"Other skin, subcutaneous tissue and breast procedures with CC"
642	Inborn and other disorders of metabolism
659	Kidney and ureter procedures for non-neoplasm with MCC
668	Transurethral procedures with MCC
754	"Malignancy, female reproductive system with MCC"
758	"Infections, female reproductive system with CC"
809	Major hematological and immunological diagnoses except sickle cell crisis and coagulation disorders with CC
812	Red blood cell disorders without MCC
813	Coagulation disorders
814	Reticuloendothelial and immunity disorders with MCC
829	Myeloproliferative disorders or poorly differentiated neoplasms with other procedures with CC/MCC
837	Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy agent with MCC
840	Lymphoma and non-acute leukemia with MCC
844	Other myeloproliferative disorders or poorly differentiated neoplastic diagnoses with CC
866	Viral illness without MCC
908	Other O.R. procedures for injuries with CC
913	Traumatic injury with MCC
917	Poisoning and toxic effects of drugs with MCC
922	"Other injury, poisoning and toxic effect diagnoses with MCC"
923	"Other injury, poisoning and toxic effect diagnoses without MCC"
933	Extensive burns or full thickness burns with MV >96 hours without skin graft
947	Signs and symptoms with MCC
Quintile 4	
73	Cranial and peripheral nerve disorders with MCC
85	Traumatic stupor and coma <1 hour with MCC
88	Concussion with MCC
98	Non-bacterial infection of nervous system except viral meningitis with CC
137	Mouth procedures with CC/MCC
140	Major head and neck procedures with MCC
143	"Other ear, nose, mouth and throat O.R. procedures with MCC"
157	Dental and oral diseases with MCC
164	Major chest procedures with CC
199	Pneumothorax with MCC
204	Respiratory signs and symptoms
240	Amputation for circulatory system disorders except upper limb and toe with CC
260	Cardiac pacemaker revision except device replacement with MCC
286	"Circulatory disorders except AMI, with cardiac catheterization with MCC"
294	Deep vein thrombophlebitis with CC/MCC
306	Cardiac congenital and valvular disorders with MCC
326	"Stomach, esophageal and duodenal procedures with MCC"
357	Other digestive system O.R. procedures with CC
370	Major esophageal disorders without CC/MCC
415	Cholecystectomy except by laparoscope without C.D.E. with CC
433	Cirrhosis and alcoholic hepatitis with CC
434	Cirrhosis and alcoholic hepatitis without CC/MCC
475	Amputation for musculoskeletal system and connective tissue disorders with CC
495	Local excision and removal of internal fixation devices except hip and femur with MCC
498	Local excision and removal of internal fixation devices of hip and femur with CC/MCC
503	Foot procedures with MCC
545	Connective tissue disorders with MCC
574	Skin graft for skin ulcer or cellulitis with CC
607	Minor skin disorders without MCC
629	"Other endocrine, nutritional and metabolic O.R. procedures with CC"
643	Endocrine disorders with MCC
660	Kidney and ureter procedures for non-neoplasm with CC
665	Prostatectomy with MCC
686	Kidney and urinary tract neoplasms with MCC
713	Transurethral prostatectomy with CC/MCC
718	Other male reproductive system O.R. procedures except malignancy without CC/MCC
729	Other male reproductive system diagnoses with CC/MCC
746	"Vagina, cervix and vulva procedures with CC/MCC"
749	Other female reproductive system O.R. procedures with CC/MCC
760	Menstrual and other female reproductive system disorders with CC/MCC
808	Major hematological and immunological diagnoses except sickle cell crisis and coagulation disorders with MCC
815	Reticuloendothelial and immunity disorders with CC
846	Chemotherapy without acute leukemia as secondary diagnosis with MCC
858	Postoperative or post-traumatic infections with O.R. procedures without CC/MCC
864	Fever and inflammatory conditions
865	Viral illness with MCC
928	Full thickness burn with skin graft or inhalation injury with CC/MCC
940	O.R. procedures with diagnoses of other contact with health services with CC
957	Other O.R. procedures for multiple significant trauma with MCC
963	Other multiple significant trauma with MCC
969	HIV with extensive O.R. procedures with MCC
988	Non-extensive O.R. procedures unrelated to principal diagnosis with CC
Quintile 5	
11	"Tracheostomy for face, mouth and neck diagnoses or laryngectomy with MCC"
25	Craniotomy and endovascular intracranial procedures with MCC
31	Ventricular shunt procedures with MCC
37	Extracranial procedures with MCC
41	"Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurostimulator"
74	Cranial and peripheral nerve disorders without MCC
121	Acute major eye infections with CC/MCC
144	"Other ear, nose, mouth and throat O.R. procedures with CC"
202	Bronchitis and asthma with CC/MCC
226	Cardiac defibrillator implant without cardiac catheterization with MCC
242	Permanent cardiac pacemaker implant with MCC
252	Other vascular procedures with MCC
255	Upper limb and toe amputation for circulatory system disorders with MCC
270	Other major cardiovascular procedures with MCC
284	"Acute myocardial infarction, expired with CC"
290	Acute and subacute endocarditis without CC/MCC
302	Atherosclerosis with MCC
329	Major small and large bowel procedures with MCC
330	Major small and large bowel procedures with CC
335	Peritoneal adhesiolysis with MCC
344	Minor small and large bowel procedures with MCC
347	Anal and stomal procedures with MCC
353	Hernia procedures except inguinal and femoral with MCC
383	Uncomplicated peptic ulcer with MCC
405	"Pancreas, liver and shunt procedures with MCC"
417	Laparoscopic cholecystectomy without C.D.E. with MCC
423	Other hepatobiliary or pancreas O.R. procedures with MCC
446	Disorders of the biliary tract without CC/MCC
465	Wound debridement and skin graft except hand for musculoskeletal and connective tissue disorders without CC/MCC
466	Revision of hip or knee replacement with MCC
477	Biopsies of musculoskeletal system and connective tissue with MCC
480	Hip and femur procedures except major joint with MCC
496	Local excision and removal of internal fixation devices except hip and femur with CC
513	"Hand or wrist procedures, except major thumb or joint procedures with CC/MCC"
516	Other musculoskeletal system and connective tissue O.R. procedures with CC
576	Skin graft except for skin ulcer or cellulitis with MCC
581	"Other skin, subcutaneous tissue and breast procedures without CC/MCC"
597	Malignant breast disorders with MCC
616	"Amputation of lower limb for endocrine, nutritional and metabolic disorders with MCC"
617	"Amputation of lower limb for endocrine, nutritional and metabolic disorders with CC"
619	O.R. procedures for obesity with MCC
693	Urinary stones with MCC
709	Penis procedures with CC/MCC
711	Testes procedures with CC/MCC
717	Other male reproductive system O.R. procedures except malignancy with CC/MCC
849	Radiotherapy
854	Infectious and parasitic diseases with O.R. procedures with CC
857	Postoperative or post-traumatic infections with O.R. procedures with CC
902	Wound debridements for injuries with CC
904	Skin grafts for injuries with CC/MCC
906	Hand procedures for injuries
